Mammography Method and Apparatus to Generate an X-Ray Tomosynthesis Image of a Breast of a Patient

1. A method to generate an x-ray tomosynthesis image of a breast of a patient comprising: operating an x-ray imaging apparatus to conduct two tomosynthesis scans in a chronological succession, each comprised of a plurality of projection images acquired at respective projection angles, with said x-ray imaging apparatus being operated at x-ray energies that differ from each other respectively in said two tomosynthesis scans; providing the projection images acquired in each of said two tomosynthesis scans to a computerized processor and, in said processor, for one of said two tomosynthesis scans, generating a synthetic projection image from at least two projection images acquired in said one of said two tomosynthesis scans, said synthetic projection image being a projection image at a projection angle that corresponds to a projection angle of one of the projection images acquired in the other of said two tomosynthesis scans; in said processor, subtracting said synthetic projection image and said one of said projection images from the other of said two tomosynthesis scans, to produce a difference image; in said processor, reconstructing an x-ray tomosynthesis image using said difference image; and making the x-ray tomosynthesis image available in electronic form at an output of said processor.

2. A method as claimed in claim 1 , comprising: operating said x-ray imaging apparatus to implement said two tomosynthesis scans by generating a first number of first projection images acquired with a first x-ray energy at respectively different first projection angles, and to generate a second number of second projection images acquired with a second x-ray energy at respectively different second projection angles; in said processor, pairing respective first and second projection angles to form respective projection angle pairs by pairing either a first projection angle with a second projection angle that is different from that first projection angle, or by pairing a second projection angle with a first projection angle that is different from that second projection angle; in said processor, generating a number, equal to said first plurality, of synthetic projection images, each synthetic projection image being formed from two adjacent first projection images, but at a projection angle equal to the projection angle of a second projection angle paired with the respective projection angle of one of said two adjacent first projection images, and replacing said one of said first projection images with the synthetic projection image formed therefrom; in said processor, forming a difference image between each synthetic projection image and the second projection image at the projection angle paired with the projection angle of said one of said two adjacent first projection images, thereby obtaining a plurality of difference images; and in said processor, reconstructing said x-ray tomosynthesis image from said plurality of difference images and any of said second projection images that were not used to form one of said difference images.

3. A method as claimed in claim 2 comprising operating said x-ray imaging apparatus with said first x-ray energy being lower than said second x-ray energy.

4. A method as claimed in claim 1 , comprising: operating said x-ray imaging apparatus to implement said two tomosynthesis scans by generating a first number of first projection images acquired with a first x-ray energy at respectively different first projection angles, and to generate a second number of second projection images acquired with a second x-ray energy at respectively different second projection angles; in said processor, pairing respective first and second projection angles to form respective projection angle pairs by pairing either a first projection angle with a second projection angle that is different from that first projection angle, or by pairing a second projection angle with a first projection angle that is different from that second projection angle; in said processor, generating a number, equal to said second plurality, of synthetic projection images, each synthetic projection image being formed from two adjacent second projection images, but at a projection angle equal to the projection angle of a first projection angle paired with the respective projection angle of one of said two adjacent second projection images, and replacing said one of said second projection images with the synthetic projection image formed therefrom; in said processor, forming a difference image between each synthetic projection image and the first projection image at the projection angle paired with the projection angle of said one of said two adjacent second projection images, thereby obtaining a plurality of difference images; and in said processor, reconstructing said x-ray tomosynthesis image from said plurality of difference images and any of said first projection images that were not used to form one of said difference images.

5. A method as claimed in claim 1 comprising generating said synthetic projection image as a weighted addition of respective projection images that are adjacent to each other in said one of said two tomosynthesis scans.

6. A method as claimed in claim 1 comprising, in said processor, generating an x-ray tomosynthesis image from the projection images in said one of said two tomosynthesis scans, and generating said synthetic projection image as a back-projection from said tomosynthesis x-ray image reconstructed from said one of said two tomosynthesis scans, at the projection angle of said projection image acquired in the other of said two tomosynthesis scans.

7. A method as claimed in claim 1 comprising generating said difference image by a weighted subtraction.

8. A method as claimed in claim 1 comprising operating said x-ray imaging apparatus to acquire all of said first projection images either before or after acquiring all of said second projection images.

9. A method as claimed in claim 1 comprising subjecting image data of the respective projection images to no image processing other than generating said synthetic projection image, said difference image and said x-ray tomosynthesis image.

10. A method as claimed in claim 1 comprising operating said x-ray imaging apparatus with contrast agent injected into the patient before acquisition of said first and second projection images.

11. A method to generate an x-ray tomosynthesis image of a breast of a patient comprising: operating an x-ray imaging apparatus to conduct two tomosynthesis scans in a chronological succession, each comprised of a plurality of plurality of projection images acquired at respective projection angles, with said x-ray imaging apparatus being operated at x-ray energies that differ from each other respectively in said two tomosynthesis scans; providing the projection images acquired in each of said two tomosynthesis scans to a computerized processor and, in said processor, for each of said two tomosynthesis scans, generating a synthetic projection image from at least two projection images acquired in that respective tomosynthesis scan, each synthetic projection image being a projection image at a same projection angle; in said processor, subtracting said synthetic projection images, to produce a difference image; in said processor, reconstructing an x-ray tomosynthesis image using said difference image; and making the x-ray tomosynthesis image available in electronic form at an output of said processor.

12. A method as claimed in claim 11 , comprising: operating said x-ray imaging apparatus to implement said two tomosynthesis scans by generating a first number of first projection images acquired with a first x-ray energy at respectively different first projection angles, and to generate a second number of second projection images acquired with a second x-ray energy at respectively different second projection angles; in said processor, pairing respective first and second projection angles to form respective projection angle pairs by pairing either a first projection angle with a second projection angle that is different from that first projection angle, or by pairing a second projection angle with a first projection angle that is different from that second projection angle; in said processor, generating a number, equal to said first plurality, of first synthetic projection images, each synthetic projection image being formed from two adjacent first projection images, but at an intermediate projection angle or at a projection angle equal to the projection angle of a second projection angle paired with the respective projection angle of one of said two adjacent first projection images, and replacing said one of said first projection images with the first synthetic projection image formed therefrom; in said processor, generating a number, equal to said second plurality, of second synthetic projection images, each synthetic projection image being formed from two adjacent second projection images, but at an intermediate projection angle or at a projection angle equal to the projection angle of a first projection angle paired with the respective projection angle of one of said two adjacent second projection images, and replacing said one of said second projection images with the synthetic projection image formed therefrom; in said processor, forming a difference image between each first synthetic projection image and second projection image at the projection angle paired with the projection angle of said one of said two adjacent first and second projection images, thereby obtaining a plurality of difference images; and in said processor, reconstructing said x-ray tomosynthesis image from said plurality of difference images and any of said projection images that were not used to form one of said difference images.

13. A method as claimed in claim 12 comprising operating said x-ray imaging apparatus with said first x-ray energy being lower than said second x-ray energy.

14. A method as claimed in claim 11 comprising generating said synthetic projection image as a weighted addition of respective projection images that are adjacent to each other in said one of said two tomosynthesis scans.

15. A method as claimed in claim 11 comprising, in said processor, generating an x-ray tomosynthesis image from the projection images in said one of said two tomosynthesis scans, and generating said synthetic projection image as a back-projection from said tomosynthesis x-ray image reconstructed from said one of said two tomosynthesis scans, at the projection angle of said projection image acquired in the other of said two tomosynthesis scans.

16. A method as claimed in claim 11 comprising generating said difference image by a weighted subtraction.

17. A method as claimed in claim 11 comprising operating said x-ray imaging apparatus to acquire all of said first projection images either before or after acquiring all of said second projection images.

18. A method as claimed in claim 11 comprising subjecting image data of the respective projection images to no image processing other than generating said synthetic projection image, said difference image and said x-ray tomosynthesis image.

19. A method as claimed in claim 11 comprising operating said x-ray imaging apparatus with contrast agent injected into the patient before acquisition of said first and second projection images.

20. A mammography apparatus comprising: an x-ray imaging apparatus; a control unit configured to operate the x-ray imaging apparatus to conduct two tomosynthesis scans in chronological succession, each comprised of a plurality of projection images acquired at respective projection angles, with said x-ray imaging apparatus being operated at x-ray energies that differ from each other respectively in said two tomosynthesis scans; a computerized processor provided with the projection images acquired in each of said two tomosynthesis scans, said computerized processor being configured to generate for one of said two tomosynthesis scans, generating a synthetic projection image from at least two projection images acquired in said one of said two tomosynthesis scans, said synthetic projection image being a projection image at a projection angle that corresponds to a projection angle of one of the projection images acquired in the other of said two tomosynthesis scans; said processor being configured to subtract said synthetic projection image and said one of said projection images from the other of said two tomosynthesis scans, to produce a difference image; said processor being configured to reconstruct an x-ray tomosynthesis image using said difference image; and said processor being configured to make the x-ray tomosynthesis image available in electronic form at an output of said processor.

21. A mammography apparatus comprising: an x-ray imaging apparatus; a control unit configured to operate the x-ray imaging apparatus to conduct two tomosynthesis scans in a chronological succession, each comprised of a plurality of projection images acquired at respective projection angles, with said x-ray imaging apparatus being operated at x-ray energies that differ from each other respectively in said two tomosynthesis scans; a computerized processor provided with the projection images acquired in each of said two tomosynthesis scans, said computerized processor being configured, for each of said two tomosynthesis scans, to generate a synthetic projection image from at least two projection images acquired in that tomosynthesis scan; said synthetic projection images each being at a same projection angle; said processor being configured to subtract said synthetic projection images, to produce a difference image; said processor being configured to reconstruct an x-ray tomosynthesis image using said difference image; and said processor being configured to make the x-ray tomosynthesis image available in electronic form at an output of said processor.